Individual provider Active NPI

Sarah Putt, OT

  • Occupational Therapist
  • Kosciusko, MS
National Provider Identifier
1144736885
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT3351 Issued in MS
Practice address
130 Parkway PLZ
Kosciusko, MS 39090-3217
Phone
(662) 289-3588
Fax
(662) 289-3533
NPI assigned
Dec 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT3351 MS Primary

Addresses

Primary practice location

130 Parkway PLZ
Kosciusko, MS 39090-3217

Mailing address

PO Box 23996
Jackson, MS 39225-3996
Phone (601) 206-6100

Other practice location 1

950 E County Line Rd Ste E
Ridgeland, MS 39157-1928
Phone (901) 853-9747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180202000900 MS Practitioner - Occupational Therapist in Private Practice 5799045175 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Mississippi LLC Occupational Therapist CurrentSince Nov 4, 2019 Accepting new patients
Premier Medical Group of Mississippi LLC CurrentSince Dec 1, 2017 Accepting new patients
Drayer Physical Therapy Mississippi LLC Past Accepting new patients
Premier Medical Group of Mississippi LLC PastSince Dec 1, 2017 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

117 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-6330

332 Highway 12 W
Kosciusko, MS 39090
Phone (601) 206-6100

130 Parkway Plz
Kosciusko, MS 39090
Phone (662) 289-3588

950 E County Line Rd
Ste E
Ridgeland, MS 39157
Phone (601) 853-8747

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1144736885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23996",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253996",
            "telephone_number": "601-206-6100",
            "fax_number": "601-206-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 PARKWAY PLZ",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903217",
            "telephone_number": "662-289-3588",
            "fax_number": "662-289-3533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "950 E County Line Rd Ste E",
            "address_purpose": "LOCATION",
            "city": "Ridgeland",
            "state": "MS",
            "postal_code": "391571928",
            "country_code": "US",
            "telephone_number": "901-853-9747",
            "fax_number": "601-898-4761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUTT",
        "first_name": "SARAH",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-18",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT3351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kosciusko, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.